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Is neuromuscular block necessary during surgery?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At May 28, 2016
Reviewed AtMarch 21, 2020

Patient's Query

Hi doctor,

I am going to have laparoscopic surgery to remove an ovarian dermoid cyst. I am afraid of being under general anesthesia in the presence of neuromuscular blocks. Is there a way to ensure that I am unconscious before administering the neuromuscular block? I have read a horrible story about someone being paralyzed first, before the other drugs took effect and being conscious during intuition. Is a neuromuscular block necessary during this entire surgery or is it only in the beginning for intubation? Is it possible that intraoperative awareness is more common than we realize, because amnesia-inducing drugs erase people's memory of it? Or would anyone with conscious during surgery also have a memory of it? Are any sort of analgesics used in this surgery? Is it true that if I experience awareness I would also be experiencing severe pain? If heart rate and blood pressure are indeed sufficient indicators of awareness, then why have other healthy young people like myself experienced awareness while paralyzed without anyone noticing their stress response and therefore deepening the anesthesia? How was that able to occur and what would prevent it from occurring in my case? I read that some drugs used in anesthesia can block the body's normal stress response, so that heart rate and blood pressure would not increase even in a state of intense pain and anxiety. Would I be receiving any drugs that would produce such an effect, blocking my body's normal stress response and preventing those indicators of awareness? Is it possible to listen to a recording on headphones while in surgery? I have a guided relaxation tape that makes me more confident. I would stay unconscious or at least be able to cope with an awareness experience. Thank you so much for reading my questions and I look forward to hearing the answers.

Hi,

Welcome to icliniq.com.

  • Normally, all anesthesia, you can see are just a prick of a needle. So, if you do not fear the prick of a needle then you need not worry.
  • Once the needle is pricked and the medicine goes in your body, you will not realize any pain neither remember anything. You would be in a deep sleep.
  • Anxiolytics are given initially to relax the mind. Sensory perception is lost first which will be confirmed by an anesthetist by pricking and then neuromuscular blocks will be given to relax muscles.
  • Neuromuscular block is necessary since it relaxes muscle and prevents muscles from undergoing reflex spasm while doing surgery. Intraoperative awareness is very rare.
  • Amnesia drugs are very effective, so you will remember nothing. You need not worry about it.
  • Neuromuscular blockers are strong analgesics too. You will have no pain perception at all.
  • Heart and blood pressure are not indicators of awareness rather they indicate that the body is functioning normally. Yes, they could demonstrate body's stress levels, but your anesthetist will take care of it.
  • Anesthesia is highly advanced nowadays and drugs blocking heart and blood pressure response are no longer used.
  • Regarding your last question, it is not possible to listen to the song on headphone. Just relax. Everything will be fine.

For further doubts consult an anesthesiologist online --> https://www.icliniq.com/ask-a-doctor-online/anesthesiologist

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Srivastava, Sumit
Dr. Srivastava, Sumit

Internal Medicine

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